Opioid Overdose Deaths

Deaths due to opioid overdose per 100,000 population 

Source:
Multiple Cause of Death Data, National Vital Statistics System, National Center for Health Statistics.
13923.5
Dashboard-City Average

Why do we measure opioid overdose deaths?

Although the U.S. opioid use crisis has affected most demographic groups, it has hit some harder than others.4 In particular, American Indian/Alaska Native and Black communities have been disproportionately affected; and males are more than twice as likely to die from opioid overdose than females.5,6 Notably, deaths are rising not only in people with opioid use disorders, but increasingly among non-frequent opioid users with a concurrent rise in unintentional overdoses.7 In 2017, the Department of Health and Human Services declared the opioid epidemic a public health emergency. Effective strategies to address the epidemic include a range of prevention approaches, such as prescription drug monitoring,as well as medication assisted treatment and naloxone distribution and administration, among others.  

How do we measure opioid overdose deaths?

This metric includes all deaths for which opioid overdose is included as a cause of death. 

Underestimation of City-Level Opioid Overdose Death Prevalence

Previous research has identified differences in how opioid-related deaths are reported across states. Differences in reporting can underestimate city-level opioid overdose deaths. For example, variability in coding procedures for opioid versus “unspecified” overdose deaths and assignment of deaths to county rather than city geographies may each contribute to underestimations.8,9 Also, recent local shifts in opioid use patterns may not be reflected in the Dashboard’s mortality estimates due to time lags. For these reasons, Dashboard estimates may not adequately reflect the current extent of the opioid epidemic, and users should consult local data sources and exercise caution when using these data. Please reach out to [email protected] with any questions, comments, or concerns.

Strengths and Limitations

Strengths of Metric

Limitations of Metric

• Opioid overdose deaths are a measure of the intensity and severity of the opioid use epidemic in a city. Other measures, like rates of non-fatal overdoses, rates of risky physician prescribing, or availability of effective treatment, can provide valuable insights into local patterns of use and strategies for addressing them.

• Opioid overdose deaths capture only the most severe outcome of opioid use, and do not reflect the far greater range of use among the broader population.

• The metric does not distinguish between deaths from different types of opioids (e.g., heroin, prescription opioids).

• In some cities and states, opioid deaths are undercounted on death certificates.8 Data users should exercise caution when comparing cities.

Calculation

Opioid overdose deaths are calculated by the following formula:

Opioid Overdose Deaths Calculation

This metric is age-adjusted to the 2010 U.S. age distribution. For more information on the calculation, please refer to the City Health Dashboard Technical Document.

Data Source

Estimates for this metric are from the Multiple Cause of Death Data from the National Vital Statistics System of the National Center for Health Statistics. Multi-year data are available for this metric. For more information, please refer to Using Multi-Year Data: Tips and Cautions. 

Opioid overdose deaths are identified by the International Disease Classification code (version 10) that classifies underlying causes of death. This metric uses the X40-44, X60-64, X85, Y10-14 underlying cause of death codes in combination with the T400-T404, and T406 multiple cause of death codes.

Years of Collection

Calculated by the Dashboard Team using data from 2021, 3 year estimate.

References

  1. Hedegaard H, Warner M, Minino AM. Drug Overdose Deaths in the United States, 1999-2016. NCHS data brief. 2017(294):1-8.

  2. Warner M, Trinidad JP, Bastian BA, Minino AM, Hedegaard H. Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2010-2014. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2016;65(10):1-15.

  3. Centers for Disease Control and Prevention. Opioid Overdose- Understanding the Epidemic. Updated August 30, 2017; https://www.cdc.gov/drugoverdose/epidemic/index.html. Accessed February 23, 2018.

  4. National Institute on Drug Abuse. Opioids. https://www.drugabuse.gov/drugs-abuse/opioids. Accessed February 23, 2018.

  5. King NB, Fraser V, Boikos C, Richardson R, Harper S. Determinants of Increased Opioid-Related Mortality in the United States and Canada, 1990–2013: A Systematic Review. American Journal of Public Health. 2014;104(8):e32-e42.

  6. Warner M, Hedegaard H. Identifying Opioid Overdose Deaths Using Vital Statistics Data. Am J Public Health. 2018;108(12):1587-1589.

  7. Buchanich JM, Balmert LC, Williams KE, Burke DS. The Effect of Incomplete Death Certificates on Estimates of Unintentional Opioid-Related Overdose Deaths in the United States, 1999-2015. Public Health Reports. 2018;133(4):423-431.

  8. Davis G, Warner M, Paulozzi L, Nolte K, Ls N. State variation in certifying manner of death and drugs involved in drug intoxication deaths. Vol 32013.

  9. Buchanich JM, Balmert LC, Williams KE, Burke DS. The Effect of Incomplete Death Certificates on Estimates of Unintentional Opioid-Related Overdose Deaths in the United States, 1999-2015. Public Health Reports. 2018;133(4):423-431. doi:10.1177/0033354918774330

  10. Davis G, Warner M, Paulozzi L, Nolte K, Ls N. State variation in certifying manner of death and drugs involved in drug intoxication deaths. vol 3. 2013:231-7.

Last updated: July 26, 2023